HomeMy WebLinkAbout249251 09/09/15 ,>> CITY OF CARMEL, INDIANA VENDOR: 369809
® 'r ONE CIVIC SQUARE ANGIE FITZPATRICK CHECK AMOUNT: $*******"15.00*
r CARMEL, INDIANA 46032 12268 CHRISTONE DR CHECK NUMBER: 249251
FISHERS IN 46037 CHECK DATE: 09/09/15
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
1096 4358400 15.00 REFUNDS AWARDS & INDE
ACTIVITY REFUND RECEIPT
_ Receipt# 1457478
Carmel @ Clayf', Payment Date: 08/25/15
J #:
Darks&Recreation Household 55879 AUG ?n�5
t
Monon Community Center Angie Fitzpatrick
Carmel IN 46032 12268 Criststone Dr.
Fishers IN 46037 Cell Ph:
angie-fitzpatrick@comcast.net
Phone: (317)848-7275
Fed Tax ID#35-6000972
Enrollment Details
CANCELLATION - Refund Of 15.00
Enrollee Name: Angie Fitzpatrick Fees+Tax Discount Prev Paid Cur Paid Amount Due
Activity Number: 158093-04 Adaptive Open Swim 0.00 0.00 0.00 0.00 0.00
Enrollment Date: 07/15/2015 (Cancelled)
Class Location: Outdr Leisure Pool Class Dates: 08/25/2015 to 08/25/2015
Monon Community Cntr 5:45P to 7:OOP
Tu
Carmel, IN 46032 Scheduled Sessions: 1
(317)848-7275
Cancel Reason: Visit Refund
PREVIOUS NET HOUSEHOLD BALANCE 0.00
Processed on 08/25/15 @ 11:13:53 by MYADON FEES CHANGED ON CANCELLED ITEMS(+) 15.00-
NET AMOUNT FROM CANCELLED ITEMS
TOTAL AMOUNT AMOUNT REFUNDED 15.00
NEW NET HOUSEHOLD BALANCE 0.00
Refund of=_> 15.00 Made By=_>REFUND FINAN With Reference=_>
All refunds are subject to State Board of Accounts procedures and may to e 4-6 weeks to process. No cash refunds will be
issued.
Authorized Signature Date Authorized Signature Date
Escape Day Passes are non-refundable.
to
Page# 1 of 1
ACCOUNTS PAYABLE VOUCHER
CITY OF CARMEL
An invoice of bill to be properly itemized must show; kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
Fitzpatrick, Angie Purchase Order No.
12268 Christone Dr Terms
Fishers, IN 46037 Date Due
Invoice Invoice Description
Date Number (or note attached invoice(s) or bill(s))
8/25/15 1457478 Refund Amount
$ 15.00
Total $ 15.00
1 hereby certify that the attached invoice(s),or bill(s)is(are)true and correct and I have audited same in accordance
with IC 5-11-10-1.6
, 20
Clerk-Treasurer
Voucher No. Warrant No.
Fitzpatrick, Angie Allowed 20
12268 Christone Dr
Fishers, IN 46037
In Sum of$
$ 15.00
ON ACCOUNT OF APPROPRIATION FOR
109 -MCC
PO#orBoard Members
Dept#
INVOICE NO. ACCT#/TITL AMOUNT
1096-70 1457478 4358400 $ 15.00 1 hereby certify that the attached invoice(s), or
bill(s)is(are)true and correct and that the
materials or services itemized thereon for
which charge is made were ordered and
received except
September 4, 2015
Signature
$ 15.00 Accounts Payable Coordinator
Cost distribution ledger classification if Title
claim paid motor vehicle highway fund